DSpace Collection:http://localhost:8080/xmlui/handle/123456789/106282026-04-08T21:06:29Z2026-04-08T21:06:29ZA Systematic Review: The Impact of COVID-19 Policy Flexibilities on SNAP and WIC Programmatic OutcomesCrespo-Bellid, MayraHeadrick, GabbyL opez, Miguel AngelHolcomb, JenniferKhan, ArianaSapkota, ShantiHollis-Hansen, Kelseannahttp://localhost:8080/xmlui/handle/123456789/106662025-06-24T02:21:41Z2024-12-20T00:00:00ZTitle: A Systematic Review: The Impact of COVID-19 Policy Flexibilities on SNAP and WIC Programmatic Outcomes
Authors: Crespo-Bellid, Mayra; Headrick, Gabby; L opez, Miguel Angel; Holcomb, Jennifer; Khan, Ariana; Sapkota, Shanti; Hollis-Hansen, Kelseanna
Abstract: ABSTRACT
In response to the coronavirus disease 2019 (COVID-19) public health emergency (PHE), the federal government deployed policy flexibilities in food and nutrition assistance programs including the Supplemental Nutrition Assistance Program (SNAP) and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) to meet the needs those experiencing economic hardship. Emergent
literature evaluates the impact of these flexibilities on program outcomes. The objective of this study was to explore the impact of policy
flexibilities deployed during the COVID-19 PHE on access, enrollment/retention, benefit utilization, and perceptions of SNAP and WIC.
Keyword searches were performed in November 2023, February 2024, and August 2024. The search included peer-reviewed literature from
2020 to 2024, following Johanna Briggs Institute (JBI) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines,
resulting in 37 eligible articles. Twelve studies evaluated policy flexibilities in SNAP only, 21 in WIC only, and 4 in both programs. Across
these, 12 studies explored program access, 7 enrollment/retention, 13 benefit utilization, and 15 program perceptions. JBI critical appraisal
tools were used to assess risk of bias. The reviewed articles show that although SNAP and WIC participants identified challenges to access,
there were increases in enrollment/retention due to policy flexibilities enabling remote services and reducing administrative burden in both
programs. Benefit increases led to greater purchase of preferred foods in SNAP and greater access to fruit and vegetables in WIC. Overall,
participants were satisfied with the flexibilities and reported most were beneficial for their households. Some implementation challenges
were identified by participants and staff. A few studies showed potential risks of bias, including selection bias and confounding bias. COVID19-related policy flexibilities in SNAP and WIC demonstrated significant improvements in selected program outcomes; however, challenges
communicating policy flexibilities to authorized vendors and participants created difficulties to benefiting from the flexibilities. Findings
from the evaluations of these flexibilities can inform future program enhancements and long-term regulatory changes. This study was
registered in PROSPERO (CRD42023493302).
Keywords: SNAP, WIC, program access, enrollment, retention, benefit utilization, policy flexibilities2024-12-20T00:00:00ZBeyond Traditional Body Composition Metrics: Load-Capacity Indices Emerge as Predictors of Cardiometabolic Outcomes—A Systematic Review and Meta-AnalysisGuan, ZhongyangMinnetti, MariannaHeymsfield, Steven BPoggiogalle, EleonoraM Prado, CarlaSim, Marchttp://localhost:8080/xmlui/handle/123456789/106652025-06-24T02:14:24Z2025-01-03T00:00:00ZTitle: Beyond Traditional Body Composition Metrics: Load-Capacity Indices Emerge as Predictors of Cardiometabolic Outcomes—A Systematic Review and Meta-Analysis
Authors: Guan, Zhongyang; Minnetti, Marianna; Heymsfield, Steven B; Poggiogalle, Eleonora; M Prado, Carla; Sim, Marc
Abstract: ABSTRACT
The adaptive and independent interrelationships between different body composition components have been identified as crucial determinants of disease risk. On the basis of this concept, the load-capacity model of body composition, which utilizes measurements obtained
through nonanthropometric techniques such as dual-energy X-ray absorptiometry, was proposed. This model is typically operationalized as
the ratio of metabolic load (adipose mass) to metabolic capacity (lean mass). In recent years, a series of load-capacity indices (LCIs) have
been utilized to identify abnormal body composition phenotypes such as sarcopenic obesity (SO) and to predict the risk of metabolic,
cardiovascular, and cognitive disorders. In this review, we comprehensively review the characteristics of different LCIs used in previous
studies, with a specific focus on their applications, especially in identifying SO and predicting cardiometabolic outcomes. A systematic
literature search was performed using PubMed, MEDLINE, PsycINFO, Embase, and the Cochrane Library. Two meta-analyses were conducted to 1) estimate the overall prevalence of SO mapped by LCIs, and 2) assess the association of LCIs with cardiometabolic outcomes. A
total of 48 studies (all observational) were included, comprising 22 different LCIs. Ten studies were included in the meta-analysis of SO
prevalence, yielding a pooled prevalence of 14.5% [95% confidence interval (CI): 9.4%, 21.6%]. Seventeen studies were included in the
meta-analysis of the association between LCIs and adverse cardiometabolic outcomes, which showed a significant association between
higher LCI values and increased risk (odds ratio ¼ 2.22; 95% CI: 1.81, 2.72) of cardiometabolic diseases (e.g. diabetes and metabolic
syndrome). These findings suggest that the load-capacity model of body composition could be particularly useful in the identification of SO
cases and prediction of cardiometabolic risk. Future longitudinal studies are needed to validate the association of LCIs with chronic cardiometabolic and neurodegenerative diseases.
This systematic review and meta-analysis has been registered with PROSPERO (CRD42024457750).
Keywords: body composition, sarcopenic obesity, cardiometabolic diseases, systematic review, meta-analysis2025-01-03T00:00:00ZThe Optimal Dosage and Duration of ω-3 PUFA Supplementation in Heart Failure Management: Evidence from a Network Meta-AnalysisTseng, Ping-TaoZeng, Bing-YanHsu, Chih-WeiLiang, Chih-SungStubbs, BrendonChen, Yen-Wenhttp://localhost:8080/xmlui/handle/123456789/106602025-06-24T02:11:07Z2025-01-11T00:00:00ZTitle: The Optimal Dosage and Duration of ω-3 PUFA Supplementation in Heart Failure Management: Evidence from a Network Meta-Analysis
Authors: Tseng, Ping-Tao; Zeng, Bing-Yan; Hsu, Chih-Wei; Liang, Chih-Sung; Stubbs, Brendon; Chen, Yen-Wen
Abstract: ABSTRACT
Heart failure is a progressive condition associated with a high mortality rate. Despite advancements in treatment, many patients continue to
experience less-than-ideal outcomes. ω-3 (n–3) polyunsaturated fatty acids (PUFAs) have been studied as a potential supplementary therapy
for heart failure, but the optimal dosage and duration of supplementation remain unclear. This network meta-analysis (NMA) aimed to
assess the efficacy of various n–3 PUFA supplementation regimens in patients with heart failure, focusing on dose-dependent and timedependent effects. We conducted a systematic search for randomized controlled trials (RCTs) on n–3 PUFA supplementation in heart
failure till 13 September, 2024. The primary outcome was the change in heart function, specifically left ventricular ejection fraction.
Secondary outcomes included changes in peak oxygen consumption (VO2), blood B-type natriuretic peptide concentrations, and quality of
life. The safety analysis focused on dropout rates (i.e., patients leaving the study for any reason before completion) and all-cause mortality. A
frequentist-based NMA was performed. This NMA, which included 14 RCTs with 9075 participants (mean age, 66.0 y; 23.3% female), found
that high-dose n–3 PUFA supplementation (2000–4000 mg/d) over a duration of 1 y significantly improved left ventricular ejection
fraction and peak VO2 compared with those of control groups. Lower doses and shorter treatment periods did not produce the same benefits.
No significant differences were found in dropout rates or all-cause mortality between the n–3 PUFAs and control groups. Long-term, highdose n–3 PUFA supplementation, particularly with a predominance of docosahexaenoic acid or eicosapentaenoic acid, enhances cardiac
function in patients with heart failure without increasing risk of adverse events. Further well-designed RCTs with long treatment durations
(i.e., >1 y) and stringent heart failure inclusion criteria are necessary to confirm these findings and reduce potential biases.
This trial was registered at PROSPERO as CRD42024590476.
Keywords: network meta-analysis, ω-3 polyunsaturated fatty acid, PUFA, EPA, DHA, heart failure, LVEF, cardiovascular disease2025-01-11T00:00:00ZSocial Vulnerability and Child Food Insecurity in Developed Countries: A Systematic ReviewMitiku Dana, LiyuworkRamos-García, C esarA Kerr, DeborahM Fry, JaneTemple, JeromeyM Pollard, Christinahttp://localhost:8080/xmlui/handle/123456789/106572025-06-24T02:07:21Z2025-01-10T00:00:00ZTitle: Social Vulnerability and Child Food Insecurity in Developed Countries: A Systematic Review
Authors: Mitiku Dana, Liyuwork; Ramos-García, C esar; A Kerr, Deborah; M Fry, Jane; Temple, Jeromey; M Pollard, Christina
Abstract: ABSTRACT
Food insecurity (FI) is a serious public health concern in economically developed countries, mainly due to unequal resource distribution.
Identifying social vulnerability factors [i.e., characteristics of a person or group regarding their capacity to anticipate, cope with, resist, and
recover from the effects of child FI (CFI)] and their positive or negative relationship with CFI is important to support targeted action with a
scale and intensity that is proportionate to the level of disadvantage. This review aimed to systematically and comprehensively identify key
social vulnerability contributors to CFI in economically developed countries and discuss the factors in the context of the socio-ecological
model. Five research databases were searched for observational studies published in 2000 assessing social vulnerability factors related to
FI in children residing in developed countries. Data screening and extraction were independently conducted by 2 reviewers who recorded
factors related to CFI. The QualSyst tool was used to assess risk of bias. From the studies identified (N ¼ 5689), 49 articles, predominantly
from the United States and Canada, met the inclusion criteria. The identified social vulnerability factors associated with CFI were grouped
into 5 based on the socio-ecological model: 1) individual child, 2) parental, 3) household, 4) community, and 5) societal factors. The most
frequently reported contributors to CFI were income (household factor). Other social vulnerability factors were identified, including the
child’s age, parental depression, household crowdedness, social connection, poverty, and residential instability. The lack of consistent
measures to define both social vulnerability and CFI in diverse population subgroups impeded meaningful pooling and interpretation of
factors interacting with CFI. Recommendations for future studies are to use comparable measures to estimate the extent and severity of CFI
and to investigate the relation between social vulnerability, severity, and trajectories of CFI in developed countries.
This trial was registered at PROSPERO as CRD42022291638.
Keywords: children, developed economies, food security, systematic review, social vulnerability, socio-ecological model2025-01-10T00:00:00Z